Individual
KESHA ELAINE GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 W 9TH AVE, WINFIELD, KS 67156-2852
(620) 402-6641
(620) 221-3350
Mailing address
118 W 9TH AVE, WINFIELD, KS 67156-2852
(620) 402-6641
(202) 213-3506
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13289
KS
104100000X
Social Worker
8983
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/16/2016
Last updated
12/20/2023
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